About one-third of Americans
between age 65 and 74 and one-half of those age 85 and older have hearing
problems. They may mistake words in a conversation, miss musical notes at
a concert, or leave a ringing door bell unanswered. Hearing problems can
be small (missing certain sounds) or large (involving total deafness).
Some people may not
admit they are having trouble hearing. But, if ignored or untreated, these
problems can get worse. Older people who canít hear well may become depressed
or withdraw from others to avoid the frustration or embarrassment of not
understanding what is being said. They may become suspicious of relatives
or friends who they believe "mumble" or "don't speak upĒ on purpose. Itís
easy to mistakenly call older people confused, unresponsive, or uncooperative
just because they donít hear well.
If you have a hearing
problem, you can get help. See your doctor. Special training, hearing
aids, certain medicines, and surgery are some of the choices that could
help people with hearing problems.
Common Signs of
See your doctor if:
- words are hard
- another personís
speech sounds slurred or mumbled, especially if it gets worse when there
is background noise,
- certain sounds
are overly annoying or loud,
- a hissing or ringing
in the background is heard,
- TV shows, concerts,
or parties are less enjoyable because you canít hear much.
Diagnosis of Hearing
Hearing loss can be caused by exposure to very loud noises over a long
period of time, viral or bacterial infections, heart conditions or stroke,
head injuries, tumors, certain medicines, heredity, or changes in the
ear that happen with aging.
If you have trouble
with your hearing, see your family doctor. In some cases, the diagnosis
and treatment can take place in his or her office. Or you may be referred
to an otolaryngologist (oto-larin-GOL-o-jist). This doctor has
special training in the ear, nose, and throat and other areas related
to the head and neck. He or she will take a medical history, ask if other
family members have hearing problems, do a thorough exam, and order any
(aw-dee-OL-o-jist) is a health professional who can identify and measure
hearing loss. He or she may work with the otolaryngologist. The audiologist
will use a device called an audiometer to test your ability to hear sounds
at different pitches and loudness. The tests are painless. Audiologists
do not prescribe drugs or perform surgery.
Types of Hearing
Presbycusis (prez-bee-KU-sis) is the most common hearing problem
in older people. In fact, people over age 50 are likely to lose some hearing
each year. Presbycusis is an ongoing loss of hearing linked to changes
in the inner ear. People with this kind of hearing loss may have a hard
time hearing what others are saying or may be unable to stand loud sounds.
The decline is slow. Just as hair turns gray at different rates, presbycusis
develops at different rates.
is also common in older people. Tinnitus is a symptom associated with
a variety of hearing diseases and disorders. People with tinnitus have
a ringing, roaring, or hear other sounds inside the ears. It may be caused
by ear wax, an ear infection, the use of too much aspirin or certain antibiotics,
or a nerve disorder. Often, the reason for the ringing cannot be found.
Tinnitus can come and go; or it can stop altogether.
loss happens in some older people when the sounds that are carried
from the ear drums (tympanic membrane) to the inner ear are blocked. Ear
wax in the ear canal, fluid in the middle ear, abnormal bone growth, or
a middle ear infection can cause this loss. Sensorineural (sen-so-ree-NU-ral)
hearing loss happens when there is damage to parts of the inner ear
or auditory nerve. The degree of hearing loss can vary from person to
person. Sensorineural hearing loss may be caused by birth defects, head
injury, tumors, illness, certain prescription drugs, poor blood circulation,
high blood pressure, or stroke.
If Someone You
Know Has A Hearing Problem
- Face the person
and talk clearly.
- Stand where there
is good lighting and low background noise.
- Speak clearly and
at a reasonable speed; do not hide your mouth, eat, or chew gum.
- Use facial expressions
or gestures to give useful clues.
- Reword your statement
- Be patient, stay
positive and relaxed.
- Ask how you may
help the listener.
- Set up meetings
so that all speakers can be seen or can use a microphone.
- Include the hearing
impaired person in all discussions about him or her to prevent feelings
Tips to Recognize
See your doctor if you have:
- Dfficulty hearing
over the telephone;
- Trouble following
a conversation when two or more people are talking at the same time;
- Others complaining
that you make the TV too loud;
- To strain to understand
- Problems hearing
because of background noise;
- The sense that
others seem to mumble; or
- Difficulty understanding
women and children talking.
If You Have Trouble
- Tell others that
you have trouble hearing.
- Ask others to face
you, speak more slowly and clearly, and not to shout.
- Pay attention to
what is being said and to facial expressions or gestures.
- Let the person
talking know if you do not understand what is being said; ask for the
statement to be repeated or reworded.
If you are having trouble hearing, the doctor may suggest using a hearing
aid. This is a small device that you put in your ear to make sounds louder.
Before buying a hearing aid, you must get a written medical evaluation
or sign a waiver saying that you do not want a medical evaluation.
There are many kinds
of hearing aids. An audiologist will consider your hearing level, ability
to understand speech, comfort in using the controls, and concern for how
it looks. He or she will then suggest a specific design, model, and brand
of hearing aid that best suits your needs.
When you buy a hearing
aid, remember you are buying a product and a service. You will need fitting
adjustments, directions to use the aid, and repairs during the warranty
Be sure to buy a
hearing aid that has only the features you need. The most costly product
may not be the best model for you, while the one selling for less may
be just right. Be aware that the controls for many hearing aids are tiny
and can be hard to adjust. This often gets easier with practice. Find
a hearing aid dealer (called a dispenser) who has the patience and skill
to help you during the month or so it takes to get used to the new hearing
For More Information
about hearing loss is available from the following groups.
of Otolaryngology-Head and Neck Surgery, Inc. (AAO HNS)
One Prince Street
Alexandria, VA 22314
AAO-HNS is an organization
of medical doctors who specialize in care of the ear, nose, throat, head,
and neck. Contact AAO-HNS for physician referrals. Send a stamped, self
addressed business envelope to receive single copies of AAO-HNS publications.
Language Hearing Association (ASHA)
10801 Rockville Pike
Rockville, MD 20852
ASHA Helpline: 1-800-638-8255 (Voice/TTY)
ASHA is a nonprofit
organization of professionals concerned with communication sciences and
disorders. ASHA offers information about hearing aids or hearing loss
and communication problems in older people. They can provide a list of
certified audiologists and speech language pathologists.
P.O. Box 5
Portland, OR 97207
ATA provides information
about tinnitus and makes professional referrals. ATA supports a nationwide
network of self-help groups for people with tinnitus and their families.
Public information includes information about prevention and treatment.
Self Help for
Hard of Hearing People, Inc. (SHHH)
7910 Woodmont Avenue
Bethesda, MD 20814
SHHH is an international
volunteer organization composed of people who are hard of hearing, their
relatives, and friends. SHHH provides self help programs and referrals
to local chapters. Contact them for a list of available publications.
Center on Deafness (NICD)
800 Florida Avenue, NE.
Washington, DC 20002
NICD provides fact
sheets, resource listings, and reading lists on all aspects of deafness
and hearing loss including educational programs, vocational training,
sign language programs, legal issues, technology, and barrier free design.
on Deafness and Other Communication Disorders (NIDCD)
National Institutes of Health
31 CENTER DR MSC 2320
BETHESDA, MD 20892-2320
NIDCD Information Clearinghouse: 1-800-241-1044
NIDCD conducts and
supports biomedical and behavioral research and training and the dissemination
of information on disorders of hearing, balance, smell, taste, voice,
speech, and language. The NIDCD Clearinghouse offers information to health
professionals, patients, industry representatives, and the public.